mohammad rouzbahani

Cardiac angiography is one of the diagnostic and therapeutic methods that impose a remarkable dose of X-rays and it can create risks for patients. It is very important to the cardiologist to control the patient's radiation exposure during the angiography. In order to optimize the use of ionization radiation, it is essential to know the average dose received by patients in the angiography department. This study aimed to evaluate the amount of x-rays received in diagnostic and interventional cardiac angiography methods in patients referred to Imam Ali Hospital in Kermanshah.

This was a cross-sectional and prospective study. 260 patients who were candidates for angiography tests during a period of 6 months were examined. The demographic information of the patients was obtained and they were divided into two diagnostic and interventional groups. A comparison was performed in terms of the amount of radiation received by patients and the consumption of contrast material in two groups. Moreover, the comparison was done between different physicians.

There was a significant difference in absorbed dose, DAP and volume of contrast agent between diagnostic angiography and interventional angiography (p<0.05). However, there was not any significant difference in absorbed dose, DAP and volume of contrast agent in diagnostic angiography and interventional angiography for different physicians (p>0.05).

This study generally indicated that absorbed dose, DAP, and the volume of contrast agent in diagnostic angiography was significantly lower than interventional angiography. However, there was not any significant relationship between different physicians in measuring parameters.

Exercise training by modulating blood pressure and heart rate have a protective role for middle-aged cardiac patients. Aim of this study was to compare the effect of eight weeks of aerobic and combined exercise on some hemodynamic indicators in middle-aged male patients undergoing coronary artery bypass graft surgery.

In this clinical trial, a sample of 30 middle-aged men who underwent coronary artery surgery in 2023 were enrolled after meeting predetermined eligibility criteria and randomized for participation. They were divided into three aerobic (n=10), combined (n=10) and control (n=10) groups. The individuals of the 2 intervention groups performed selected aerobic and combined exercises (with an intensity of 55 - 75% of the maximum heart rate, for 60 minutes) for 8 weeks, 3 sessions per week. Blood pressure, heart rate and peripheral oxygen saturation (SpO2) were measured before and after the intervention. The parametric paired sample t-test, one-way ANOVA test and Tukey's Test were used to examine differences at a significance level of P ≤ 0.05.

The effect of aerobic exercises on systolic blood pressure (P=0.036), diastolic blood pressure (P=0.040) and heart rate (P=0.013) was significant and caused a decrease in these indicators, but the decrease in the combined group was not significant (P>0.05). The intergroup effect difference was not significant (P>0.05). In both aerobic (P=0.000) and combined (P=0.007) groups, the peripheral oxygen saturation has increased significantly and intergroup mean difference was significant (P=0.004).

It seems that aerobic and combined exercises as a helpful intervention strategy to improve hemodynamic indicators, make the patient more adaptable to the conditions after coronary artery bypass graft surgery.

 Hemorhological disorders are one of the primary causes of cardiovascular diseases. Accordingly, aerobic and combined exercises can improve hemorhological indicators and reduce cardiovascular complications in high-risk people.

 This study aimed to compare the effects of eight weeks of aerobic and combined exercise on some hemorheological indicators in middle-aged male patients undergoing Coronary Artery Bypass Graft Surgery.

 This experimental study was conducted in 2023 on 30 middle-aged men (Age, 57.63 ± 6.38, BMI, 26.61 ± 3.60) undergoing Coronary Artery Bypass Graft Surgery in Kermanshah, Iran, who were divided into aerobic (10 people), combined (10 people), and control (10 people) groups. The intervention groups received selected exercises for eight weeks (24 sessions). Serum hemoglobin, hematocrit, fibrinogen, and erythrocyte sedimentation rate (ESR) were measured before and after the intervention. The parametric paired sample t-test and one-way ANOVA test were used to examine differences at a significance level of P ≤ 0.05.

 The effect of combined exercises on hemoglobin and hematocrit was significant (P ≤ 0.05), but the amount of reduction in the aerobic group was not significant (P > 0.05). Findings in the fibrinogen and ESR variables showed a significant decrease in both aerobic and combined groups (P ≤ 0.05). There was no significant difference between the effect of eight weeks of aerobic and combined training on the variables of hemoglobin, hematocrit, fibrinogen, and ESR (P > 0.05).

 Based on the results, aerobic and combined exercises effectively improved the hemorheological indicators and overall conditions of patients who underwent Coronary Artery Bypass Graft Surgery. Therefore, these exercises should be included in the cardiac rehabilitation program as an effective treatment method.

Breast cancer is one of the most common cancers and the fifth leading cause of cancer deaths in Iran. The present study aimed to investigate the absorbed dose received by the heart and its relationship with cardiac complications in radiotherapy of patients with left breast cancer using a three-dimensional conformal radiotherapy technique.

A total of 181 women with left breast cancer who received radiotherapy after surgery were included in the study. Dosimetric parameters were obtained using dose-volume histograms for the heart, whole lung, left lung, and clinical target volume. Electrocardiography tests were performed for all patients before and one year after the radiotherapy.

The mean doses of heart, left lung, whole lung, and clinical target volume were 6.3±3.1, 13.3±4.5, 6.9±3.7, and 47.3±6.4 Gray (Gy), respectively. A significant reduction in T-wave amplitude was observed in 57% of patients three months after radiotherapy. T-wave amplitude decreased from 3.03±0.92 mm to 1.56±0.83 mm. The reduction in the T-wave amplitude displayed a significant relationship with the mean dose of the heart (β = 2.653; P= 0.019).

In women with left-sided breast cancer, cardiac complications are frequent, for which electrocardiographic tests can be used for cardiac evaluation after radiotherapy. Based on the obtained results, the most frequent side effect caused by radiotherapy in these patients was an abnormality in T-wave

 Little is known about the predictors of left ventricular ejection fraction (LVEF) —an important predictor of mortality— after primary percutaneous coronary intervention (PCI) in low- and middle-income countries.

 In a prospective cohort study at Imam Ali hospital, Kermanshah, Iran, we enrolled consecutive ST-elevation myocardial infarction (STEMI) patients treated with primary PCI (2016-2018) and followed them up to one year. LVEF levels were measured by echocardiography, at baseline and one-year follow-up. Determinants of preserved/improved LVEF were assessed using multi-variable logistic regression models.

 Of 803 patients (mean age 58.53±11.7 years, 20.5% women), baseline LVEF levels of ≤35% were reported in 44%, 35- 50% in 40%, and ≥50% in 16% of patients. The mean ± SD of LVEF increased from 38.13%±9.2% at baseline to 41.49%±9.5% at follow-up. LVEF was preserved/improved in 629 (78.3%) patients. Adjusted ORs (95% CIs) for predictors of preserved/improved LVEF showed positive associations with creatinine clearance, 1.01 (1.00-1.02) and adherence to clopidogrel, 2.01 (1.33-3.02); and inverse associations with history of myocardial infarction (MI), 0.44 (0.25-0.78); creatine kinase MB (CK-MB), 0.997 (0.996- 0.999); door-balloon time (3rd vs. 1st tertile), 0.62 (0.39-0.98); number of diseased vessels (2 and 3 vs. 1: 0.63 (0.41-0.99) and 0.58 (0.36-0.93), respectively); and baseline LVEF (35-50% and ≥50% vs. ≤35%: 0.45 (0.28-0.71) and 0.19 (0.11-0.34), respectively).

 Adherence to clopidogrel, short door-balloon time, high creatinine clearance, and lower baseline LVEF were associated with preserved/improved LVEF, while history of MI, high CK-MB, and multi-vessel disease were predictors of reduced LVEF. Long-term drug adherence should be considered for LVEF improvement in low- and middle-income countries.

Obesity is strongly associated with increased cardiovascular diseases (CVD) and cardiovascular risk factors, such as diabetes mellitus, hypertension, and dyslipidemia. However, numerous studies have suggested the existence of an “obesity paradox” in which overweight and mildly obese patients often exhibit a better outcome than their leaner counterparts. Therefore, this study aimed to characterize the association between BMI and in-hospital and one-year outcomes. This hospital-based research was conducted as a part of the Kermanshah STEMI Registry. Following the application of inclusion criteria, a total of 2,397 STEMI patients were evaluated. The data were collected using a standardized case report developed by the European Observational Registry Program (EORP). Body mass index (BMI) (kg/m2) was classified into underweight (<18.5), normal weight (18.5–24.9), overweight (25–29.9), class I/mild obese (30–34.9), and class II/extreme obese (≥35) categories. The independent predictors of the in-hospital and one-year outcomes were assessed using multivariable logistic regression models.  Out of the 2397 patients, 43 (1.79%) were underweight, 934 (38.97%) were normal, 1038 (43.30%) were overweight, 322 (13.43%) were class I obese, and 60 (2.50%) were class II obese. The results of the crude analysis showed that class I obesity was protective against CV death (OR 0.50; 95% CI 0.30-0.84), MACE3 (MI, stroke, and death) (OR 0.47; 95% CI 0.29-0.76), and MACE5 (MACE3 plus unstable angina and heart failure) (OR 0.59; 95% CI 0.44-0.79).  Multivariate adjustment eliminated the protective effect of class I obesity against death and MACE events. Therefore, it is possible that this protective effect does not exist and instead reflects the impact of confounding variables such as age.

Acute Myocardial Infarction (AMI) is the leading cause of global mortality. Moreover, Left Ventricular Ejection Fraction (LVEF) is the most important predictor of post-AMI mortality. Thus, the present study aimed to investigate the relationship between smoking cessation and LVEF following one year from the STEMI.

CASE REPORT: 

The present study was a part of the Kermanshah STEMI Registry and included 825 smokers admitted to Imam Ali Hospital, Kermanshah, Iran, with AMI during a 2-year study period. Data collection was performed using the standardized case report form by the European Observational Registry Program (EORP). Moreover, multiple logistic regression was used to compare LVEF between the patients who had quit smoking post-AMI and those who were still smokers after one year. Also, one-to-one Propensity Score Matching (PSM) was used to reduce the assessment error and selection bias, increase the result accuracy, and minimize the effects of confounders on the LVEF-smoking relationship.

Following one year after AMI, 219 (26.55%) patients had quit smoking, while 606 (73.45%) still smoked. Using the PSM, a total of 168 ex-smokers were matched to 168 current smokers. Moreover, it was shown that LVEF was higher in current smokers compared to ex-smokers. However, the difference was not significant. Also, multiple logistic regression showed that the Odds Ratio (OR) of LVEF reduction was insignificantly higher in ex-smokers (OR=1.13; 95% CI: 0.98-1.29) compared to current smokers. Multivariate regression analysis found similar results even after the application of PSM (OR 1.02; 95% CI: 0.82-1.22).

Given the low rate of smoking cessation after MI, physicians are recommended to ask about the smoking status of MI patients at each office visit or re-admission and strongly recommend quitting smoking.

BACKGROUND AND

Cardiovascular diseases (CVDs) are the most important cause of death in Iran and the Kermanshah province. One of the most important problems that cardiovascular patients are dealing with is the psychological consequences of their illness. This study aimed at investigating the effectiveness of Meaning‑Centered Group Psychotherapy (MCGP) intervention in improving spiritual well‑being and reducing anxiety in cardiovascular patients.

The study population included all patients referred to specialized cardiovascular centers in Kermanshah province in 2019. The participants consisted of 30 patients who were randomly assigned into experimental and control groups after the primary and secondary screening. The experimental group received routine treatment + MCGP (8 weeks and 90–120 min per session) and the control group only received routine treatment. The dependent variables were assessed by Spiritual Well‑Being Scale and Beck Anxiety Inventory before and after receiving the treatment and 2 months after the treatment. ANCOVA and multivariate analysis of covariance were applied to the data through SPSS‑22. IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.

The results of covariance analysis showed that MCGP increased spiritual/existential well‑being and decreased anxiety in the experimental group (P < 0.001), while no significant difference was traced in the control group.

The findings of this randomized controlled trial provide good evidence for the effectiveness of MCGP as a treatment to improve the psychological and spiritual/existential distress in patients with CVDs.

Contrast-induced nephropathy (CIN) is the third cause of hospital-acquired acute kidney injury. The CIN prophylactic strategies adopted to date, although not highly efficient, are mostly based on antioxidant activity and hydration therapy. This study was designed and conducted to evaluate crocin’s efficacy in the prevention of CIN in chronic kidney disease (CKD) patients undergoing coronary angiography/angioplasty. In this randomized clinical trial, a total of 110 eligible CKD stage 3 patients requiring contrast agent administration for coronary angiography/angioplasty were enrolled and randomly assigned to either crocin (n = 57) or control (n = 53) group. The patients in both groups received standard hydration therapy; nevertheless, in the crocin group, the patients were also orally administered three consecutive oral doses of 30 mg crocin tablets 1 day before up to 1 day after contrast media (CM) exposure. The primary endpoint was CIN incidence defined as an increase in serum creatinine (SrCr) level by ≥ 0.3 mg/dL or any change in urinary neutrophil gelatinase-associated lipocalin (NGAL) from the baseline within 48 hours of CM exposure. During 4 months, 130 patients were recruited. The mean age of the patients was 65.62 ± 9.05 years, and the majority of them were male (64.54%). The SrCr in the crocin group did not significantly increase within 48 hours of angiography/angioplasty. The changes in the urinary NGAL level were not significant in both groups. The CIN incidence was significantly lower in the crocin group than in the control group (1.75% and 13.2%; P = 0.028). Crocin administration plays an important nephron-protective role in the prevention of CIN.

Considerable variability in survival rate after ST-segment elevation myocardial infarction (STEMI) is present and outcomes remain suboptimal, especially in low- and middle-income contraries. This study aimed to investigate predictors of 30- day mortality after STEMI, including reperfusion therapy, in a tertiary hospital in western Iran.

In this registry-based cohort study (2016–2019), we investigated reperfusion therapies – primary percutaneous coronary intervention (PPCI), pharmaco-invasive (thrombolysis followed by angiography/percutaneous coronary intervention), and thrombolysis alone – used in Imam-Ali hospital, the only hospital with a PPCI capability in the Kermanshah Province. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs), using Cox proportional-hazard models, to investigate the potential predictors of 30-day mortality including reperfusion therapy, admission types (direct admission/referral from non-PPCI-capable hospitals), demographic variables, coronary risk factors, vital signs on admission, medical history, and laboratory tests.

Data of 2428 STEMI patients (mean age: 60.73; 22.9% female) were available. Reperfusion therapy was performed in 84% of patients (58% PPCI, 10% pharmaco-invasive, 16% thrombolysis alone). Only 17% of the referred patients had received thrombolysis at non-PPCI-capable hospitals. Among patients with thrombolysis, only 38.2% underwent coronary angiography/ percutaneous coronary intervention. The independent predictors of mortality were: no reperfusion therapy (HR: 2.01, 95% CI: 1.36–2.97), referral from non-PPCI-capable hospitals (1.73, 1.22–2.46), age (1.03, 1.01–1.04), glomerular filtration rate (0.97, 0.96–0.97), heart rate>100 bpm (1.94, 1.22–3.08), and systolic blood pressure<100 mm Hg (4.92, 3.43–7.04). Mortality was lower with the pharmaco-invasive approach, although statistically non-significant, than other reperfusion therapies.

Reperfusion therapy, admission types, age, glomerular filtration rate, heart rate, and blood pressure were independently associated with 30-day mortality. Using a comprehensive STEMI network to increase reperfusion therapy, especially pharmaco-invasive therapy, is recommended.

breast arterial calcification (BAC) is one of the most prevalent mammographic findings and has been debated as a marker of cardiovascular disease (CVDs). The present study aimed to assess the findings of stress echo in women with BAC.

This cross-sectional study was conducted on women who undergo mammography for routine breast cancer screening at Imam Reza hospital, western Iran from March 2018 to July 2018. The patients underwent stress echocardiography to evaluate the probability of myocardial ischemia (MI). Chi-square and independent t-tests were used to assess the differences between subgroups.

BAC was present in 61 (15.2%) women. The mean age of the patients with BAC was significantly higher than the patients without BAC (58.59± 7.82 vs. 55.32±6.57, p =0.003). Prevalence rates of the menopause (88.5% vs. 71.1%, p=0.009), hypertension (29.5% vs. 17.7%, p=0.032), and hypercholesterolemia (24.6% vs. 13.0, p=0.018) were significantly higher in the patients with BAC compared to the patients without BAC. The prevalence rate of MI symptoms in the patients with BAC was equal to 24.6%. Significantly, more women with BAC were positive for myocardial ischemia compared to the women without BAC (24.6% vs. 8.5%, p<0.001). The prevalence rates of the diabetes mellitus, hypertension, hypercholesterolemia, and history of CVDs were significantly higher in the patients who were positive for MI.

It was found that BACs are correlated with an increased occurrence rate of CVDs. Our results illustrated that the patients who were positive for MI were more plausible to be diabetic, hyperlipidemic, hypertensive, and having a history of CVDs.

 Acute myocardial infarction is one of the most common heart diseases. Troponin I and troponin T are biomarkers for the diagnosis of cardiac cell necrosis in patients with acute coronary syndrome.In addition to myocardial infarction, exercise and strenuous physical activity can cause acute increases in troponin I and troponin T. The purpose of this study was to provide a systematic review of studies on the effects of physical activity and exercise on cardiac troponins.

Search for studies on troponin I and troponin T in exercise and physical activity in the reputable databases Springer, Hindawi, PubMed, Google Scholar, Scopus, SID and ISC using the keyword Exercise induced troponin, Exercise-induced cardiac injury, Troponin release, Exercise and troponin, and Myocardial infarction and troponin were performed.

In a review of marathon studies showing 11 studies were reviewed, the number of athletes was 881, in 593 (67%), increase in troponin was observed, In the endurance Running competitions with the mentioned conditions, 4 articles were reviewed, The number of athletes was 118, with a 65% increase in troponin. In 5 studies related to the effect of walking on troponin, 194 athletes were studied, which in 8% of cases showed increase in troponin. In a review of three studies in the Ironman Triathlon, 58 athletes were studied, with a 69% increase in troponin. Also, in 5 studies on the effect of cycling exercise on troponin, 94 athletes were studied, As a result, increase in troponin was seen in 27% of athletes.

Troponin I and troponin T in prolonged or strenuous exercise should be monitored carefully. The more intense and time the exercise, The increase in troponin is also greater. In such cases, there is a risk of Myocardial infarction. Knowing the difference between the approximate time of increase and decrease of troponin after myocardial infarction and exercise can be helpful in diagnosing whether the increase in troponin is pathological or physiological.

Retroperitoneal Hematoma (RPH) is one of the most serious complications after Intra-Aortic Balloon Pump (IABP) insertion. Although advances in clinical experience regarding IABP insertion have led to a decrease in vascular complications such as RPH, its rate has remained considerably high.

This study aimed to evaluate the factors predicting RPH following IABP insertion site injury.

This retrospective cohort study of 2508 patients undergoing off-pump Coronary Artery Bypass Graft (CABG) surgery over 4.5 years allowed the identification and evaluation of all patients with RPH. The patients were divided into with RPH and without RPH groups. RPH prediction was analyzed by multivariate stepwise logistic regression analysis. SPSS, version 22 (SPSS Inc., Chicago, IL) was used for statistical analysis.

RPH developed in 16 patients (overall prevalence: 0.63%), with the highest frequency in low ejection fraction patients (3%). Female gender, compartment syndrome, IABP insertion site, preoperative Clopidogrel usage, use of post-operative inotropic drugs, and body surface area were the predictors of RPH in multivariate analysis. Moreover, in-hospital mortality was significantly higher in the patients who had developed RPH compared to those who had not (50% vs. 1.9%, P = 0.004).

RPH is a serious vascular access site complication of IABP, which has been associated with high morbidity and mortality. The current study findings indicated that such factors as female gender, BSA, IABP insertion site, preoperative Clopidogrel usage, IABP usage, and post-operative inotrope drugs use could predict RPH. Identification of RPH risk factors could in turn prevent this problem.

This study was conducted to investigate prevalence and predictors of slow coronary flow phenomenon (SCF) phenomenon.

This cross-sectional study was performed at Imam Ali Cardiovascular Hospital affiliated with the Kermanshah University of Medical Sciences (KUMS), Kermanshah province, Iran. From March 2017 to March 2019, all the patients who underwent coronary angiography were enrolled in this study. Data were obtained using a checklist developed based on the study’s aims. Independent samples t tests and chi- square test (or Fisher exact test) were used to assess the differences between subgroups. Multiple logistic regression model was applied to evaluate independent predictors of SCF phenomenon.

In this study, 172 (1.43%) patients with SCF phenomenon were identified. Patients with SCF were more likely to be obese (27.58±3.28 vs. 24.12±3.26, P<0.001), hyperlipidemic (44.2 vs. 31.7, P<0.001), hypertensive (53.5 vs. 39.1, P<0.001), and smoker (37.2 vs. 27.2, P=0.006). Mean ejection fraction (EF) (51.91±6.33 vs. 55.15±9.64, P<0.001) was significantly lower in the patients with SCF compared to the healthy controls with normal epicardial coronary arteries. Mean level of serum triglycerides (162.26±45.94 vs. 145.29±35.62, P<0.001) was significantly higher in the patients with SCF. Left anterior descending artery was the most common involved coronary artery (n = 159, 92.4%), followed by left circumflex artery (n = 50, 29.1%) and right coronary artery (n = 47, 27.4%). Body mass index (BMI) (OR 1.78, 95% CI 1.04-2.15, P<0.001) and hypertension (OR 1.59, CI 1.30-5.67, P=0.003) were independent predictors of SCF phenomenon.

The prevalence of SCF in our study was not different from the most other previous reports. BMI and hypertension independently predicted the presence of SCF phenomenon.

Circadian variation is known as an important factor in acute myocardial infarction (AMI). Moreover, the circadian pattern may help in disease prevention and better medication prescription. Therefore, the aim of our study was to investigate the circadian pattern of symptom onset in patients with ST-segment elevation myocardial infarction (STEMI).

This cross-sectional study was conducted on 777 patients admitted to the Imam Ali Cardiovascular Center, Kermanshah, Iran, with a diagnosis of STEMI from March 2018 to February 2019. Data were collected using a checklist developed based on the study's objectives. Differences between subgroups were assessed using one-way analysis of variance (ANOVA) with post-hoc testing and chi-square test (or Fisher’s exact test).

Out of the 777 patients, 616 (79.3%) were men. The mean and standard deviation (SD) of age of the patients was 60.93 ± 12.86 years. 380 patients (48.9%) were current smoker, 40.3% were hypertensive, 21.1% had hypercholesterolemia, 18.3% had diabetes mellitus (DM), 25.2% had history of angina, and about 15.0% had history of myocardial infarction (MI). The occurrence of STEMI was most common during hours between 06:01-12:00 (27.7%), followed by 12:01-18:00 (27.3%), 00:00-06:00 (24.3%), and 18:01-24:00 (20.7%), respectively. Gender was significantly associated with circadian pattern of STEMI. Women showed a double peak of symptom onset in 06:01-12:00 and 12:01-18:00.

The present study of Iranian patients displayed circadian pattern of STEMI with 2 peaks in the morning and afternoon, and the both peaks were dominated by women.

Coronary artery disease (CAD) is a costly problem and its presentations and risk factors may differ by sex. 

This study aimed to evaluate the risk factors profile and angiographic pattern of the patients undergoing coronary angiography, according to their gender.

This cross-sectional study was conducted on 741 patients who were referred for coronary angiography from March to August 2018 at Imam Ali cardiovascular center, western Iran. Using a checklist, we collected the demographic, clinical, biochemical, and lab parameters and angiographic findings in these patients. Also, differences between groups were compared using Chi-square and independent t-tests. 

Women were different from men in terms of the prevalence of hypertension (71.7% vs. 45.3%), diabetes mellitus (34.9% vs. 17.8%), and hypercholesterolemia (26.4% vs. 17.1%). Whereas, men were more likely to be smoker (28.7% vs. 0%) and obese (42.09±16.68 vs. 29.12±4.72). Total Cholesterol and Triglycerides were higher in women compared to men, which were statistically significant. Glucose plasma was significantly higher in women compared to men (p=0.01).  Both atherogenic (low-density lipoprotein (LDL)) and protective (high-density lipoprotein (HDL)) cholesterol were higher in women than men. Women were more likely to take antiplatelet (i.e. Aspirin) and antihypertensive therapies (i.e. beta-Blocker, angiotensin receptor blockers (ARBs), and angiotensin converting enzyme (ACE) inhibitors) than men. Also, it was shown that, Men were more likely to have two-vessel disease (p=0.041) and three-vessel disease (P=0.013) compared to women. Disease in the right coronary artery (RCA) (28.9% vs. 14.4%), circumflex (LCx) (26.0% vs. 15.3%), and left anterior descending (LAD) (37.8% vs. 26.4%) was more plausible to occur in men compared to women (p≤0.05). 

Access and use of health care programs are needed to control CAD risk factors. The findings of the current study showed the significance of gender in the extent of coronary artery blockages.

Treatment of myocardial infarction (MI) has been successfully developed, especially after introducing primary percutaneous coronary intervention (PPCI) as it nowadays is the recommended treatment for ST-segment elevation myocardial infarction (STEMI). 

This study aimed to evaluate the in-hospital mortality of STEMI patients treated with PPCI according to gender and other likely risk factors. 

This cross-sectional study presents a part of the results of a single-center registry in Imam Ali cardiovascular center affiliated to Kermanshah University of medical science (KUMS). From June 2016 to December 2017, 731 consecutive patients undergoing PPCI registered. Data were collected using a case report form developed by European Observational Registry Program (EORP). The relationship between in-hospital mortality and predicting variables was assessed using the Chi-square test, t-test, and univariate and multivariate logistic regression models (Forward LR). 

Totally, 155 patients (approximately 21%) were female. The mean age of women and men was 65.2 and 57.5, respectively (p=0.001). There were differences between women and men in hypertension (58.1% vs. 30.4%, respectively, p=0.001), diabetes mellitus (26.5% vs. 14.9%; p=0.001), hypercholesterolemia (37.4% vs. 18.6%; p=0.001), and history of prior congestive heart failure (5.2% vs. 2.0%; p=0.016). Although more men were current smokers (58.7% (men) vs. 15.5% (women); p=0.001). Women had a significantly greater incidence of multi-vessel disease, thrombolysis in myocardial infarction (TIMI) flow grade of 0/1 before PPCI, and longer symptom-to-balloon time. In-hospital mortality was higher in women than in men (5.2% vs. 1.9%; p=0.024). Multivariate analysis identified age ≥ 60 years, Killip class≥ II, and post-procedural TIMI flow grade < 3, but not female sex, as independent predictors of in-hospital mortality. 

In-hospital mortality after PPCI in women was higher than men, though this difference was likely due to the severe clinical profile in women. Also, female gender was not identified as an independent predictor of death.